MBBS OSCE · Vascular Surgery

OSCE — varicose veins assessment and venous ulcer plan

OSCE on CEAP classification, duplex mapping, ABPI before compression, endovenous first-line therapy, and four-layer compression for C6 venous ulcer.

8 min stationVerification in progress
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Exam tags

NEET-PGINICETUSMLEPLAB

Brief (to candidate)

A 48-year-old woman has aching varicosities and medial ankle pigmentation. A second station prompt shows a medial gaiter ulcer. ABPI 1.0. Assess and manage in 8 minutes.

Candidate instructions

  1. History: pregnancy, standing work, DVT, prior surgery.
  2. Examine distribution, skin changes, pulses/ABPI.
  3. State CEAP class.
  4. Request duplex (superficial reflux + deep patency).
  5. Plan: compression class II; EVLA/RFA for truncal reflux; ulcer → multilayer compression; biopsy if non-healing.

Examiner checklist

DomainExpected
CEAPCorrect C class (C4 pigmentation; C6 active ulcer)
DuplexMaps reflux; excludes deep obstruction before stripping/ablation
ConservativeElevation, exercise, Class II 18–24 mmHg if arterial OK
InterventionEndovenous thermal first-line; CLASS evidence
UlcerFour-layer compression; treat reflux to reduce recurrence
Red flagsMarjolin if atypical chronic ulcer; bleeding varix first aid

Common errors

  • Compression without ABPI.
  • Surgery without duplex deep-vein assessment.
  • Confusing arterial and venous ulcer sites.

Model key actions

  • CEAP correctly; duplex maps GSV/SSV reflux and confirms deep patency.
  • Class II compression only after ABPI confirms safe arterial inflow.
  • Offer EVLA/RFA first for truncal reflux (CLASS); foam for tributaries.
  • C6 ulcer: multilayer compression + treat reflux to reduce recurrence; biopsy non-healing ulcers.

Common errors

  • Stripping without duplex deep-vein assessment.
  • Full compression when ABPI under 0.8.
  • Missing Marjolin risk in chronic atypical ulcers.
References3Show
  1. [1]Lurie F, et al. The 2020 update of the CEAP classification system and reporting standards. J Vasc Surg Venous Lymphat Disord, 2020.PMID 32113854
  2. [2]Gloviczki P, et al. The care of patients with varicose veins and associated chronic venous diseases: clinical practice guidelines. J Vasc Surg, 2011.PMID 21536172
  3. [3]Brittenden J, et al. A randomized trial comparing treatments for varicose veins (CLASS). N Engl J Med, 2014.PMID 25251616
OSCE — varicose veins assessment and venous ulcer plan · MBBS OSCE · NeetVellum